The budget framework provides for 0.2 per cent real growth in health spending over the MTEF. FFC welcomed government's efforts at obtaining value for money from health spending. However, the Commission was concerned at the impact of fiscal consolidation to the quality of health care in an environment where provinces put salaries as a first claim on the fiscus above medicines and the maintenance and upkeep of medical equipment. There will need to be tighter monitoring of health budgets in the medium term.